MEDICARE: ENGLEWOOD CHIROPRACTIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHR.0006070	CO

General Provider Information

NPI Number	:	1780052134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENGLEWOOD CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	3648 S GALAPAGO ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-3421
Country	:	US
Telephone Number	:	303-789-3648
Fax Number	:

Provider Business Practice Location Address
First Line	:	3648 S GALAPAGO ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-3421
Country	:	US
Telephone Number	:	303-789-3648
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUSTIN ATKINSON
Credential	:
Telephone Number	:	303-618-8006

Provider Enumeration Date	:	09/02/2015
Last Update Date	:	09/02/2015

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